Provider Demographics
NPI:1134510332
Name:BELEAN, CORINA (ACNP-BC)
Entity Type:Individual
Prefix:
First Name:CORINA
Middle Name:
Last Name:BELEAN
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54791 GRENELEFE CIR E
Mailing Address - Street 2:
Mailing Address - City:SOUTH LYON
Mailing Address - State:MI
Mailing Address - Zip Code:48178-9482
Mailing Address - Country:US
Mailing Address - Phone:248-631-6212
Mailing Address - Fax:
Practice Address - Street 1:28050 GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-5919
Practice Address - Country:US
Practice Address - Phone:248-471-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704270341363LP0808X, 363LA2100X
NC5009093363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MB3483663OtherDEA
OR161133OtherNORTH BEND MEDICAL CENTER GROUP DMAP
MB3483663OtherDEA
OR500683741Medicaid
OR93-0635514OtherNORTH BEND MEDICAL CENTER GROUP TAX ID#
OR1407812365OtherNORTH BEND MEDICAL CENTER GROUP NPI